Buttressing hepaticojejunostomy's with hepatic round ligament flap may be beneficial
Journal Title: Polish Journal of Surgery - Year 2017, Vol 89, Issue 4
Abstract
Background: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. Methods: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ. The postoperative outcomes measured were the presence of bile leak and anastomotic stricture. Results: Forty-one patients (27 M: 14 F), aged 2-79 years, median age of61 years, underwent HJ with HRL buttress; 27 for periampullary/ head of the pancreas carcinoma; 4 for choledochal cysts; 4 for chronic pancreatitis; 3 for gallbladder carcinoma; 3 for benign biliary stricture. The time for harvesting HRL flaps and buttressing HJ was <10 minutes. No blood was lost during harvesting the flaps. One patient (2.5 %) had grade A leak following radical cholecystectomy, and structures were not observed during a median follow-up of 18 months (6 months to 2years). Conclusion: HRL-based buttressing of HJ can reduce the bile leak and/or stricture rate.<br/><br/>
Authors and Affiliations
Jayant Kumar Banerjee, Ramanathan Saranga Bharathi, Pankaj Purushotam Rao
Keywords
Related Articles
- EP ID EP218433
- DOI 10.5604/01.3001.0010.3901
- Views 82
- Downloads 0
Characteristics and results of treatment of patients treated surgically with colorectal cancer in old and senile age
Colorectal cancer (CC) in Poland is the type of cancer with the highest dynamics of disease growth and is epidemiologically related to age. The analysis involved 353 patients operated on due to CC in senile and old age a...
A Case of Portomesenteric Venous Gas Detected on Computed Tomography
Portomesenteric vein gas is a rare condition, which patogenesis is not completly understood. One of causes is e.g. mesenteric ischemia. Patogenesis of this condition are: intraabdominal sepsis, interventional procedures,...
Single incision laparoscopic cholecystectomy – making it cost-effective
-
Evaluation of the effects of mammography screening program on cancer progression and implemented treatment in patients with breast cancer
The primary goal of mammography screening is to decrease mortality in patients with breast cancer. The aim of the study was evaluation of the screening program results on course of implemented therapy and its results in...
Evaluation of patient feedback following laparoscopic cholecystectomy based on information described in the informed consent form developed by the Association of Polish Sur
The cholecystectomy procedure is the most routinely performed intervention in general surgery. The current international gold standard is via the laparoscopic approach. It is a safe, minimally-invasive procedure; however...